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A 1-year community-based health economic study of ciprofloxacin vs usual antibiotic treatment in acute exacerbations of chronic bronchitis: the Canadian Ciprofloxacin Health Economic Study Group.

https://arctichealth.org/en/permalink/ahliterature206818
Source
Chest. 1998 Jan;113(1):131-41
Publication Type
Article
Date
Jan-1998
Author
R. Grossman
J. Mukherjee
D. Vaughan
C. Eastwood
R. Cook
J. LaForge
N. Lampron
Author Affiliation
Department of Respiratory Medicine, Mount Sinai Hospital, Toronto, ON.
Source
Chest. 1998 Jan;113(1):131-41
Date
Jan-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anti-Infective Agents - adverse effects - economics - therapeutic use
Bronchitis - drug therapy - economics
Canada
Chronic Disease
Ciprofloxacin - adverse effects - economics - therapeutic use
Cost-Benefit Analysis
Female
Follow-Up Studies
Health Care Costs
Hospitalization - economics
Humans
Male
Middle Aged
Predictive value of tests
Quality-Adjusted Life Years
Recurrence
Treatment Outcome
Abstract
To evaluate the costs, consequences, effectiveness, and safety of ciprofloxacin vs standard antibiotic care in patients with an initial acute exacerbation of chronic bronchitis (AECB) as well as recurrent AECBs over a 1-year period.
Randomized, multicenter, parallel-group, open-label study.
Outpatient general practice.
A total of 240 patients, 18 years or older with chronic bronchitis, with a history of frequent exacerbations (three or more in the past year) presenting with a type 1 or 2 AECB (two or more of increased dyspnea, increased sputum volume, or sputum purulence).
The assessment included AECB symptoms, antibiotics prescribed, concomitant medications, adverse events, hospitalizations, emergency department visits, outpatient resources such as diagnostic tests, procedures, and patient and caregiver out-of-pocket expenses. Patients completed the Nottingham Health Profile, St. George's Respiratory Questionnaire, and the Health Utilities Index. The parameters were recorded with each AECB and at regular quarterly intervals for 1 year. These variables were compared between the ciprofloxacin-treated group and the usual-care-treated group.
Patients receiving ciprofloxacin experienced a median of two AECBs per patient compared to a median of three AECBs per patient receiving usual care. The mean annualized total number of AECB-symptom days was 42.9+/-2.8 in the ciprofloxacin arm compared to 45.6+/-3.0 days in the usual-care arm (p=0.50). The overall duration of the average AECB was 15.2+/-0.6 days for the ciprofloxacin arm compared to 16.3+/-0.6 days for the usual-care arm. Treatment with ciprofloxacin tended to accelerate the resolution of all AECBs compared to usual care (relative risk=1.20; 95% confidence interval [CI], 0.91 to 1.58; p=0.19). Treatment assignment did not affect the interexacerbation period but a history of severe bronchitis, prolonged chronic bronchitis, and an increased number of AECBs in the past year were associated with shorter exacerbations-free periods. There was a slight, but not statistically significant, improvement in all quality of life measures with ciprofloxacin over usual care. The only factors predictive of hospitalization were duration of chronic bronchitis (odds ratio=4.6; 95% CI, 1.6, 13.0) and severity of chronic bronchitis (odds ratio=4.3; 95% CI, 0.8, 24.6). The incremental cost difference of $578 Canadian in favor of usual care was not significant (95% CI, -$778, $1,932). The cost for the ciprofloxacin arm over the usual care arm was $18,588 Canadian per quality-adjusted life year gained. When the simple base case analysis was expanded to examine the effect of risk stratification, the presence of moderate or severe bronchitis and at least four AECBs in the previous year changed the economic and clinical analysis to one favorable to ciprofloxacin with the ciprofloxacin-treated group having a better clinical outcome at lower cost ("win-win" scenario).
Treatment with ciprofloxacin tended to accelerate the resolution of all AECBs compared to usual care; however, the difference was not statistically significant. Further, usual care was found to be more reflective of best available care rather than usual first-line agents such as amoxicillin, tetracycline, or trimethoprim-sulfamethoxazole as originally expected. Despite the similar antimicrobial activities and broad-spectrum coverage of both ciprofloxacin and usual care, the trends in clinical outcomes and all quality of life measurements favor ciprofloxacin. In patients suffering from an AECB with a history of moderate to severe chronic bronchitis and at least four AECBs in the previous year, ciprofloxacin treatment offered substantial clinical and economic benefits. In these patients, ciprofloxacin may be the preferred first antimicrobial choice.
PubMed ID
9440580 View in PubMed
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The 2-year costs and effects of a public health nursing case management intervention on mood-disordered single parents on social assistance.

https://arctichealth.org/en/permalink/ahliterature191135
Source
J Eval Clin Pract. 2002 Feb;8(1):45-59
Publication Type
Article
Date
Feb-2002
Author
Maureen Markle-Reid
Gina Browne
Jacqueline Roberts
Amiram Gafni
Carolyn Byrne
Author Affiliation
System-Linked Research Unit on Health and Social Service Utilization, School of Nursing, McMaster University, Room 3N46, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5, Canada. mreid@mcmaster.ca
Source
J Eval Clin Pract. 2002 Feb;8(1):45-59
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Case Management - economics
Child
Cost-Benefit Analysis
Depressive Disorder - economics - nursing - rehabilitation
Employment
Female
Health Care Costs
Health Services - utilization
Health Services Accessibility
Humans
Male
Ontario
Public Assistance
Public Health Nursing - economics
Single Parent - psychology
Social Adjustment
Abstract
This randomized controlled trial was designed to evaluate the 2-year costs and effects of a proactive, public health nursing case management approach compared with a self-directed approach for 129 single parents (98% were mothers) on social assistance in a Canadian setting. A total of 43% of these parents had a major depressive disorder and 38% had two or three other health conditions at baseline.
Study participants were recruited over a 12 month period and randomized into two groups: one receiving proactive public health nursing and one which did not.
At 2 years, 69 single parents with 123 children receiving proactive public health nursing (compared with 60 parents with 91 children who did not receive public health nursing services) showed a slightly greater reduction in dysthymia and slightly higher social adjustment. There was no difference between the public health and control groups in total per parent annual cost of health and support services. However, costs were averted due to a 12% difference in non-use of social assistance in the previous 12 months for parents in the public health nursing group. This translates into an annual cost saving of 240,000 dollars (Canadian) of costs averted within 1 year for every 100 parents.
In the context of a system of national health and social insurance, this study supports the fact that it is no more costly to proactively service this population of parents on social assistance.
PubMed ID
11882101 View in PubMed
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A 3-year follow-up of a multidisciplinary rehabilitation programme for back and neck pain.

https://arctichealth.org/en/permalink/ahliterature61395
Source
Pain. 2005 Jun;115(3):273-83
Publication Type
Article
Date
Jun-2005
Author
Jensen IB
Bergström G
Ljungquist T
Bodin L
Author Affiliation
Section for Personal Injury Prevention, Karolinska Institutet, Box 127 18, 112 94 Stockholm, Sweden. irene.jensen@cns.ki.se
Source
Pain. 2005 Jun;115(3):273-83
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Adult
Back Pain - economics - rehabilitation
Cognitive Therapy
Comparative Study
Cost-Benefit Analysis
Delivery of Health Care - utilization
Employment
Female
Follow-Up Studies
Health Care Costs
Humans
Male
Middle Aged
Neck Pain - economics - rehabilitation
Pensions
Physical Therapy (Specialty) - economics - organization & administration
Program Evaluation
Quality of Life
Rehabilitation - economics - organization & administration
Research Support, Non-U.S. Gov't
Sick Leave
Abstract
The aim of the present study was to evaluate the long-term outcome of a behavioural medicine rehabilitation programme and the outcome of its two main components, compared to a 'treatment-as-usual' control group. The study employed a 4 x 5 repeated-measures design with four groups and five assessment periods during a 3-year follow-up. The group studied consisted of blue-collar and service/care workers on sick leave, identified in a nationwide health insurance scheme in Sweden. After inclusion, the subjects were randomised to one of the four conditions: behaviour-oriented physiotherapy (PT), cognitive behavioural therapy (CBT), behavioural medicine rehabilitation consisting of PT+CBT (BM) and a 'treatment-as-usual' control group (CG). Outcome variables were sick leave, early retirement and health-related quality of life. A cost-effectiveness analysis, comparing the programmes, was made. The results showed, consistently, the full-time behavioural medicine programme being superior to the three other conditions. The strongest effect was found on females. Regarding sick leave, the mean difference in the per-protocol analysis between the BM programme and the control group was 201 days, thus reducing sick leave by about two-thirds of a working year. Rehabilitating women has a substantial impact on costs for production losses, whereas rehabilitating men seem to be effortless with no significant effect on either health or costs. In conclusion, a full-time behavioural medicine programme is a cost-effective method for improving health and increasing return to work in women working in blue-collar or service/care occupations and suffering from back/neck pain.
PubMed ID
15911154 View in PubMed
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[25 years of free abortion. Jubilee of abortion law in Denmark]

https://arctichealth.org/en/permalink/ahliterature64136
Source
Nord Med. 1998 Dec;113(10):350
Publication Type
Article
Date
Dec-1998
Author
L B Knudsen
B. Petersson
K. Helweg-Larsen
Author Affiliation
Demografisk Forskningscenter, Odense Universitet.
Source
Nord Med. 1998 Dec;113(10):350
Date
Dec-1998
Language
Danish
Publication Type
Article
Keywords
Abortion, Induced - economics - history
Denmark
Female
Health Care Costs
History, 20th Century
Humans
Legislation, Medical - history
Pregnancy
PubMed ID
9894413 View in PubMed
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28-Joint count disease activity score at 3 months after diagnosis of early rheumatoid arthritis is strongly associated with direct and indirect costs over the following 4 years: the Swedish TIRA project.

https://arctichealth.org/en/permalink/ahliterature137343
Source
Rheumatology (Oxford). 2011 Jul;50(7):1259-67
Publication Type
Article
Date
Jul-2011
Author
Eva Hallert
Magnus Husberg
Thomas Skogh
Author Affiliation
Department of Medical and Health Sciences, Center for Medical Technology Assessment, Linköping University, Linköping, Sweden. eva.hallert@liu.se
Source
Rheumatology (Oxford). 2011 Jul;50(7):1259-67
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Arthritis, Rheumatoid - diagnosis - economics - therapy
Cohort Studies
Cost of Illness
Disease Progression
Female
Follow-Up Studies
Health Care Costs
Health Expenditures
Humans
Linear Models
Male
Middle Aged
Predictive value of tests
Prospective Studies
Risk assessment
Severity of Illness Index
Sweden
Time Factors
Abstract
To explore possible association between disease activity at 3-month follow-up after RA diagnosis and costs over the following 4 years.
Three-hundred and twenty patients with early (= 1 year) RA were assessed at regular intervals. Clinical and laboratory data were collected and patients reported health-care utilization and number of days lost from work. At 3-month follow-up, patients were divided into two groups according to disease activity, using DAS-28 with a cut-off level at 3.2. Direct and indirect costs and EuroQol-5D over the following 4 years were compared between the groups. Multivariate regression models were used to control for possible covariates.
Three months after diagnosis, a DAS-28 level of = 3.2 was associated with high direct and indirect costs over the following 4 years. Patients with DAS-28 = 3.2 at 3-month follow-up had more visits to physician, physiotherapist, occupational therapist and nurse, higher drug costs, more days in hospital and more extensive surgery compared with patients with 3-month DAS-28
PubMed ID
21292734 View in PubMed
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[58 people with bullet wounds in Gothenburg during 18 months. This demonstrates the need for preparedness and competence within trauma care].

https://arctichealth.org/en/permalink/ahliterature273221
Source
Lakartidningen. 2015;112
Publication Type
Article
Date
2015
Author
Björn Holmström
Sven Alhbin
David Pazooki
Hans Granhed
Source
Lakartidningen. 2015;112
Date
2015
Language
Swedish
Publication Type
Article
Keywords
Adolescent
Adult
After-Hours Care
Aged
Blood pressure
Clinical Competence
Emergency Medical Services - standards
Health Care Costs
Humans
Injury Severity Score
Length of Stay
Male
Middle Aged
Retrospective Studies
Sweden - epidemiology
Wounds, Gunshot - economics - epidemiology - mortality
Abstract
From 1 January 2013 to 30 June 2014, 58 patients sustained gunshot wounds in the city of Gothenburg. 57 were males and the median age was 26 years. The majority of injuries were musculoskeletal. Ten patients died, of these 4 patients suffered single gunshot wounds to the head, while 6 patients had wounds to mediastinal structures and large abdominal vessels. 90 % of patients presented out-of-hours. The total length of stay for the 47 patients admitted was 316 days. Direct health care costs were calculated to 6.2 MSEK.
PubMed ID
26173141 View in PubMed
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[A blood transfusion in Sweden--the societal cost].

https://arctichealth.org/en/permalink/ahliterature166918
Source
Lakartidningen. 2006 Sep 20-26;103(38):2752-6
Publication Type
Article

Access to primary health care among homeless adults in Toronto, Canada: results from the Street Health survey.

https://arctichealth.org/en/permalink/ahliterature131318
Source
Open Med. 2011;5(2):e94-e103
Publication Type
Article
Date
2011
Author
Erika Khandor
Kate Mason
Catharine Chambers
Kate Rossiter
Laura Cowan
Stephen W Hwang
Author Affiliation
Toronto Public Health, Toronto, Ontario, Canada.
Source
Open Med. 2011;5(2):e94-e103
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Chronic Disease - epidemiology
Communication Barriers
Cost of Illness
Family Practice - statistics & numerical data
Female
Health Care Costs
Health Services Accessibility - economics - statistics & numerical data
Health Status Disparities
Health Surveys
Homeless Persons - psychology - statistics & numerical data
Humans
Male
Middle Aged
Ontario - epidemiology
Primary Health Care - economics - statistics & numerical data
Risk factors
Sexual Behavior - statistics & numerical data
Substance-Related Disorders - epidemiology
Abstract
Despite experiencing a disproportionate burden of acute and chronic health issues, many homeless people face barriers to primary health care. Most studies on health care access among homeless populations have been conducted in the United States, and relatively few are available from countries such as Canada that have a system of universal health insurance. We investigated access to primary health care among a representative sample of homeless adults in Toronto, Canada.
Homeless adults were recruited from shelter and meal programs in downtown Toronto between November 2006 and February 2007. Cross-sectional data were collected on demographic characteristics, health status, health determinants and access to health care. We used multivariable logistic regression analysis to investigate the association between having a family doctor as the usual source of health care (an indicator of access to primary care) and health status, proof of health insurance, and substance use after adjustment for demographic characteristics.
Of the 366 participants included in our study, 156 (43%) reported having a family doctor. After adjustment for potential confounders and covariates, we found that the odds of having a family doctor significantly decreased with every additional year spent homeless in the participant's lifetime (adjusted odds ratio [OR] 0.91, 95% confidence interval [CI] 0.86-0.97). Having a family doctor was significantly associated with being lesbian, gay, bisexual or transgendered (adjusted OR 2.70, 95% CI 1.04-7.00), having a health card (proof of health insurance coverage in the province of Ontario) (adjusted OR 2.80, 95% CI 1.61-4.89) and having a chronic medical condition (adjusted OR 1.91, 95% CI 1.03-3.53).
Less than half of the homeless people in Toronto who participated in our study reported having a family doctor. Not having a family doctor was associated with key indicators of health care access and health status, including increasing duration of homelessness, lack of proof of health insurance coverage and having a chronic medical condition. Increased efforts are needed to address the barriers to appropriate health care and good health that persist in this population despite the provision of health insurance.
Notes
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PubMed ID
21915240 View in PubMed
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[Actual cost of complex surgical treatment of patients with neuroischemic form of diabetic foot syndrome].

https://arctichealth.org/en/permalink/ahliterature266227
Source
Khirurgiia (Mosk). 2015;(4):48-53
Publication Type
Article
Date
2015
Author
V A Mitish
F T Mahkamova
Iu S Paskhalova
V A Gruzman
I I Margolina
S L Sokov
Source
Khirurgiia (Mosk). 2015;(4):48-53
Date
2015
Language
Russian
Publication Type
Article
Keywords
Adult
Aged
Diabetic Angiopathies - complications
Diabetic Foot - economics - etiology - surgery
Diabetic Nephropathies - complications
Female
Follow-Up Studies
Health Care Costs - statistics & numerical data
Humans
Male
Middle Aged
Prospective Studies
Russia
Syndrome
Vascular Surgical Procedures - economics
Abstract
The results of calculation the average cost of complex surgical treatment of 52 patients with neuroischemic form of diabetic foot syndrome (Wagner 3, 4) are presented in the article. Calculation was performed in the program "Computer-aided system for calculation of patient's treatment cost" developed in A.V. Vishnevsky Institute of Surgery. This program permits you to analyze such components as hospital-stay duration, cost of surgery, pre- and postoperative management, pharmacotherapy, laboratory and instrumental research methods. Actual cost necessary to prevent high lower extremity amputations in patients with neuroischemic form of diabetic foot syndrome is 458 387.8 rubles per person that 10.02 times higher than amount allocated from the state budget.
PubMed ID
26081187 View in PubMed
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Acute care utilization due to hospitalizations for pediatric lower respiratory tract infections in British Columbia, Canada.

https://arctichealth.org/en/permalink/ahliterature118363
Source
BMC Health Serv Res. 2012;12:451
Publication Type
Article
Date
2012
Author
Pablo Santibanez
Katherine Gooch
Pamela Vo
Michelle Lorimer
Yurik Sandino
Author Affiliation
Abbott Laboratories, 200 Abbott Park Road, Abbott Park, IL 60064, USA.
Source
BMC Health Serv Res. 2012;12:451
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
British Columbia - epidemiology
Child
Child, Preschool
Confidence Intervals
Critical Care - utilization
Databases, Factual
Health Care Costs
Hospitalization - trends
Humans
Infant
Length of Stay - trends
Respiratory Tract Infections - classification - epidemiology - therapy
Abstract
Pediatric LRTI hospitalizations are a significant burden on patients, families, and healthcare systems. This study determined the burden of pediatric LRTIs on hospital settings in British Columbia and the benefits of prevention strategies as they relate to healthcare resource demand.
LRTI inpatient episodes for patients
Notes
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PubMed ID
23217103 View in PubMed
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1640 records – page 1 of 164.